Appendix 400-28-165

 

SFN 23, Application for Approval for Relative Child Care Provider 400-28-165-05

(Revised 8/1/2023)

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SFN 23, Application for Approval for Relative Child Care Provider is to be completed by an individual choosing to become an approved relative provider for child care.

 

This form is available through the Department of Health and Human Services and may also be obtained electronically via E-Forms.

 

E-Forms are presented in Adobe Acrobat and require the Adobe Acrobat reader. If you do not currently have Adobe Acrobat reader installed, you may download a free copy by clicking the Get Adobe Reader icon below.